Histological features of lymph node metastasis in patients with biliary tract cancer

Morimoto, Haruki; Ajiki, Tetsuo; Ueda, Takashi; Sawa, Hirofumi; Fujita, Tsunenori; Matsumoto, Ippei; Yasuda, Takeo; Fujino, Yasuhiro; Kuroda, Yoshikazu; Ku, Yonson

doi:10.1002/jso.20963

Cited by 8 publications

(3 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The criteria proposed as diagnostic of metastatic LN involvement on CT of the abdomen are: size of >10 mm; a round shape, and a heterogeneous internal architecture . The poor sensitivity (14.7%) and positive predictive value (33.3%) reported in the present series highlight the fact that a significant number of patients without these radiological characteristics were found to have 16b1 LN metastatic involvement; this is consistent with previous reports . Although 18 FDG‐positron emission tomography (PET) has been used to identify metastatic LNs in patients with biliary cancer, its sensitivity is low .…”

Section: Discussionsupporting

confidence: 85%

Role of routine 16b1 lymph node biopsy in the management of gallbladder cancer: an analysis

Agarwal

Kalayarasan²,

Javed³

et al. 2014

HPB

View full text Add to dashboard Cite

show abstract

Section: Discussionsupporting

confidence: 85%

Role of routine 16b1 lymph node biopsy in the management of gallbladder cancer: an analysis

Agarwal

Kalayarasan²,

Javed³

et al. 2014

HPB

View full text Add to dashboard Cite

show abstract

“…This limitation should be kept in mind, as the sensitivity of currently available imaging methods to predict nodal involvement is poor [17,26]. Other groups have considered elective nodal irradiation to be appropriate due to a high likelihood of lymph node involvement in approximately 75-80% of patients who underwent surgical resection for pancreatic tumors [5,18].…”

Section: F-imrtmentioning

confidence: 99%

Volumetric Modulated Arc Therapy for Advanced Pancreatic Cancer

et al. 2010

View full text Add to dashboard Cite

Background: Intensity-modulated radiotherapy (IMRT) allows for improved sparing of organs at risk (OARs) in advanced pancreatic cancer. A planning study evaluated if volumetric modulated arc therapy (RapidArc™ [RA]) could be used as an alternative to IMRT in such cases. Patients and Methods: In ten patients, five-field IMRT (5f-IMRT) plans with fixed gantry positions were compared to RA plans using similar constraints for planning target volume (PTV) and OARs. PTV coverage, conformity indices (CI), and OAR doses were compared. One patient was treated using RA and calculated dose distributions were measured in coronal planes in a solid-water phantom. Results: RA plans showed superior mean CI of 1.09 ± 0.02 (± 1 SD [standard deviation]) versus 1.20 ± 0.10 in 5f-IMRT (p = 0.003). Both techniques achieved similar sparing of the right kidney, but RA significantly reduced left kidney doses with V 15 of 7.2% ± 5.3% and 15.9% ± 11.1%, respectively; p = 0.02. RA modestly decreased mean doses to liver (13.8 vs. 15.1 Gy; p = 0.003), stomach (16.7 vs. 17.9 Gy; p = 0.017), small bowel (19.8 vs. 22.1 Gy; p < 0.001), and duodenum (38.8 vs. 41.9 Gy; p = 0.004). Film dosimetry revealed excellent agreement between calculated and measured dose distributions. The delivery time for RA was < 3 min. Conclusion: RA planning achieved superior CI for pancreatic tumors compared to 5f-IMRT, and modestly reduced OAR doses. Fast treatment delivery using RA may decrease the risk of intrafractional organ motion. Ergebnisse: RA-Pläne zeigten einen günstigeren CI von 1,09 ± 0,02 (± 1 SD [Standardabweichung]) gegenüber 1,20 ± 0,10 bei 5f-IMRT (p = 0,003). Mit beiden Techniken gelang eine zufriedenstellende Dosisreduktion der rechten Niere, mittels RA konnten jedoch die V 15 der linken Niere signifikant reduziert werden (7,2% ± 5,3% vs. 15,9% ± 11,1% bei IMRT; p = 0,02). Geringer zeigte sich die Reduktion der mittleren Dosis der Leber (13,8 vs. 15,1 Gy; p = 0,003), des Magens (16,7 vs. 17,9 Gy; p = 0,017), des Dünndarms (19,8 vs. 22,1 Gy; p < 0,001) und des Duodenums (38,8 vs. 41,9 Gy; p = 0,004). Filmdosimetrische Überprüfungen zeigten hervorragende Übereinstimmungen bezüglich kalkulierter und tatsächlicher Dosisverteilung. Die Gesamtbestrahlungszeit betrug < 3 min. Schlussfolgerung: Mittels RA-Planung lässt sich im Vergleich zur 5f-IMRT sowohl ein günstigerer CI als auch moderate Dosisreduktion in den OAR erreichen. Durch die rasche Dosisapplikation vermindert sich das Risiko intrafraktionärer Bewegung der OAR.Schlüsselwörter: Pankreaskarzinom · "Volumetric modulated arc therapy" · Intensitätsmodulierte Radiotherapie · Planungsstudie · Risikoorgane

show abstract

“…Still, in resectable PDAC, conventional imaging methods, such as computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography, and endoscopic ultrasound, are not accurate for the prediction of nodal metastases [7,8]. The major reason is that a small lymph node with a short-axis diameter of less than 10 mm can also be metastatic in PDAC [9,10]. Consequently, preoperative diagnosis of small lymph node metastases (less than 10 mm) remains a challenge.…”

Section: Introductionmentioning

confidence: 99%

Establishment of a multi-parameters MRI model for predicting small lymph nodes metastases (<10 mm) in patients with resected pancreatic ductal adenocarcinoma

Shi

Liu

et al. 2021

Abdom Radiol

View full text Add to dashboard Cite

Purpose To evaluate the potential role of MR findings and DWI parameters in predicting small regional lymph nodes metastases (with short-axis diameter < 10 mm) in pancreatic ductal adenocarcinomas (PDACs). Methods A total of 127 patients, 82 in training group and 45 in testing group, with histopathologically diagnosed PDACs who underwent pancreatectomy were retrospectively analyzed. PDACs were divided into two groups of positive and negative lymph node metastases (LNM) based on the pathological results. Pancreatic cancer characteristics, short axis of largest lymph node, and DWI parameters of PDACs were evaluated. Results Univariate and multivariate analyses showed that extrapancreatic distance of tumor invasion, short-axis diameter of the largest lymph node, and mean diffusivity of tumor were independently associated with small LNM in patients with PDACs. The combining MRI diagnostic model yielded AUCs of 0.836 and 0.873, and accuracies of 81.7% and 80% in the training and testing groups. The AUC of the MRI model for predicting LNM was higher than that of subjective MRI diagnosis in the training group (rater 1, P = 0.01; rater 2, 0.008) and in a testing group (rater 1, P = 0.036; rater 2, 0.024). Comparing the subjective diagnosis, the error rate of the MRI model was decreased. The defined LNM-positive group by the MRI model showed significantly inferior overall survival compared to the negative group (P = 0.006). Conclusions The MRI model showed excellent performance for individualized and noninvasive prediction of small regional LNM in PDACs. It may be used to identify PDACs with small LNM and contribute to determining an appropriate treatment strategy for PDACs.

show abstract

Histological features of lymph node metastasis in patients with biliary tract cancer

Abstract: Although large LNs are highly suggestive of metastasis, poor detection of many small LNs with a low percentage of metastatic area can increase risk in patients with biliary tract cancer.

Cited by 8 publications

References 29 publications

Role of routine 16b1 lymph node biopsy in the management of gallbladder cancer: an analysis

Role of routine 16b1 lymph node biopsy in the management of gallbladder cancer: an analysis

Volumetric Modulated Arc Therapy for Advanced Pancreatic Cancer

Establishment of a multi-parameters MRI model for predicting small lymph nodes metastases (<10 mm) in patients with resected pancreatic ductal adenocarcinoma

Contact Info

Product

Resources

About